Bridges

The first step is to design and plan the bridge, similar to a construction blueprint, to optimize its size, shape, your bite and access for cleaning. During the second step, your teeth are carefully and meticulously shaped in preparation to support the eventual finished bridge. During this same shaping and measuring appointment, a temporary acrylic (plastic) bridge is made which will keep the shaped teeth comfortable, protect them and allow you to eat, speak and have a normal appearance between appointments.  Also during this second step, measurements or molds are made from which a precisely fitted and natural appearing bridge can be custom made in the dental laboratory.  The laboratory process of making your bridge occurs between appointments and is completed by specially trained laboratory technicians. The final steps involve completion of any adjustments to your bridge and its attachment, after which your bridge is not removable.

A bridge is most commonly made using an inner framework of alloyed gold (usually silver color) for strength and an outer layer of ceramic which is tooth colored.  Bridges can be made entirely of gold in which case they are usually yellow in color.  A tooth which supports a bridge may first require a filling to eliminate defects created by previous decay, fractures or old deteriorated fillings.  When a tooth is severely broken down, root canal treatment may be required in order to allow the use of a post inside the root to rigidly hold a large foundation filling, which would then provide a solid foundation and prevent the bridge from coming loose.  Root canal treatment may also be required before or after a bridge is placed if the nerve in the center of the tooth becomes infected or abscessed.

High quality, natural looking bridges need to be more than just ‘white’, they must approximate the complex color scheme of your other teeth or they will stick out like a ‘sore thumb’. Color is approximately matched using standardized color tabs which are selected with your approval and is included in basic bridge fees. If your bridge is prominently visible, some degree of additional customization will usually be required to more closely match your other teeth. This customization process can proceed until the best possible match is obtained subject to the limitations of man-made materials and fees based on the length of time required for customization. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made bridge and your natural teeth. Natural teeth will tend to slowly darken with age. Teeth replaced and restored with a bridge will remain the same color.

Shape is extremely critical and is one of the most frequently overlooked aspects of many bridges. This has resulted in an otherwise attractive smile being ruined by bridges not matching the remaining teeth and appearing as if they stick out. Proper shape is also required to prevent food jamming between teeth and to permit easy and thorough cleaning to avoid bad breath.

Red, blue or swollen gums and gum recession are ugly and can be caused by improperly made bridges. The gum around the bridge made with gentle techniques should be pink, firm, not bleed during cleaning and not suffer significant recession.

A well made bridge should have a perfect bite and feel completely even with the other teeth on the very first day and does not require time to settle in.  An uneven bite will either be uncomfortable or allow your teeth to shift and become crooked.

The shape of the teeth under a bridge is extremely critical.  If properly designed and shaped, bridges should not fall off and should look like they have an excellent alignment and appearance.  Expert treatment during the shaping of the teeth when the bridge is first made can essentially eliminate needless future costs of re-attaching or remaking a bridge that won’t stay on.  Mistakes in shaping the teeth for a bridge can cause harm to the gum or the tooth nerve resulting in the need for additional expensive treatment at best and at worst, can not be undone or reversed resulting in a permanent defect.

A bridge should feel comfortable, look natural and maintain or restore your ability to eat and speak.  Our patients routinely can’t feel much difference between a real tooth and a bridge.

Do not expect your general dentist to obtain the results routinely obtainable in our prosthodontic specialty office.  General dentists try to stay on top of all the general routine treatments patients need but can’t be expected to be capable of providing specialized treatment.  There are some capable dental specialists in Mexico and elsewhere but always beware of ‘discount dentistry’.  An attempt to obtain specialty treatment from those without the appropriate training and experience is likely to create problems and regret.

Most bridges fail because of tooth decay under the edge of the bridge or gum disease, both of which are frequently caused by average or poor fitting bridges and inadequate cleaning. An extremely well fitting bridge is less likely to allow decay to get under the bridge destroying the tooth underneath it. A bridge that can be properly cleaned will last much longer, increasing the likelihood that you will keep your teeth a lifetime and reduce future dental care and costs.

Cleaning teeth with bridges is not too different from cleaning natural teeth. You must thoroughly brush your teeth and clean between the teeth and under the replacement teeth using the appropriate cleaning aid every day. You will be shown and coached on the techniques necessary to care for your bridge and supporting teeth. Bridges and their supporting teeth must be regularly cleaned and checked by your dentist to ensure the gum and bone does not break down or the supporting teeth do not get cavities or decay.  An extremely well fitting bridge, that can be properly cleaned will last much longer and increase the likelihood you will keep your teeth a lifetime at less cost. A bridge with average or poor fit can’t be cleaned properly and is not likely to last long.

Bridges should be strong and not easily break. Unfortunately, elsewhere, in an effort to decrease costs, bridges can be made cheaply and from weaker materials with very unfortunate results.

By using specialized knowledge, skill and experience in combination with careful planning and attention to detail, a bridge can be made with excellent fit, appearance and function and usually be made to last for many years.